The overall goal of the NCTN Program is to conduct definitive, randomized, late phase clinical treatment trials and advanced imaging trials across a broad range of diseases and diverse patient populations, as well as development efforts preliminary to those trials, as part of the NCI's overall clinical research program for adults and children with cancer. The mission of the NCIC CTG is to develop and conduct clinical trials aimed at improving the treatment and prevention of cancer with the ultimate goal of reducing morbidity and mortality from this disease. The overlaps of these goals create a rationale for a Canadian Collaborating Clinical Trials Network. This rationale is further supported by similar societal expectations by Canadians and Americans for improved health outcomes and similar respective strategic priorities of NCIC CTG and the NCTN that recognize that new understandings of the molecular basis of carcinogenesis have the potential to advance health care delivery, including through improved therapeutic targeting of the cancer cell and better identification of therapies for individual patients. The specific objectives of NCIC CTG to collaborate with NCI/CTEP and US-based groups, through its newly-formed National Clinical Trials Network Program, to develop new Intergroup trials under NCIC CTG leadership and to ensure more rapid accrual to trials led by US-based groups, to enhance the scientific content of these trials through evaluation of additional endpoints and to contribute to new understandings of clinical trial methodology and analysis. This aim is facilitated by NCIC CTG's unique information technology supports and understandings of the Canadian regulatory environment. The aims of this application are to facilitate Canadian leadership of NCTN trials that represent value from the perspective of expenditure of U.S. federal dollars and to conduct U.S.-led NCTN trials in Canada.